Rogelio P. Nogales vs. Capitol Medical Center, et al.

G.R. No. 142625. December 19, 2006

Facts:

The parties in this case are petitioner Rogelio P. Nogales, husband of Corazon Nogales,
and respondents Capitol Medical Center, Drs. Estrada, Villaflor, Uy, Enriquez, Lacson,
Espinola and Nurse Dumlao.

Corazon Nogales was under the exclusive prenatal care of Dr. Oscar Estrada. While
Corazon was on her last trimester of pregnancy , Dr. Estrada noted an increase in her
blood pressure and development of leg edema indicating preeclampsia, which is a
dangerous complication of pregnancy. Corazon was admitted at Capitolo Medical Center
(CMC). Rogelio Nogales, the husband of Corazon, executed and signed the “Consent on
Admission and Agreement” and “Admission Agreement”

Both release forms consist of two parts. The first part gave CMC permission to administer
to Corazon any form of recognized medical treatment which the staff deemed advisable.
The second part of the documents , which may properly described as the releasing part,
releases CMC and its employees “from any and all claims “ arising from or by reason of
the treatment and operation.

In the delivery room, Corazon’s bag of water ruptured spontaneously. Corazon’s cervix
was fully dilated and started to experience convulsions. Dr. Estrada, assisted by Dr.
Villaflor, ordered 10g of magnesium sulfate , however, only 2.5g of magnesium sulfate
was administered.

Dr. Estrada and Dr. Villaflor applied low forceps to extract Corazon’s baby. In the
process, 1x2.5cm piece of cervical tissue was allegedly torn. After the baby came out,
Corazon began to manifest vaginal bleeding whch became continuous. The assisting
nurse administered hemacel through a guage 19 needle side drip to the ongoing
intravenous injection of dextrose.

Rogelio was made to sign “Consent to Operation” for the immediate hysterectomy to be
conducted by Dr. Espinola. Due to the inclement weather then, Dr. Espinola who was
fetched by an ambulance, arrived at the CMC about an hour later or at 9:00 a.m. Despite,
efforts, Corazon died due to “hemorrhage , post partum.”

Petitioners filed a complaint for damages with the RTC. Petitioners contended that
defendant physicians and CMC personnel were negligent in the treatment and
management of Corazon’s condition. Petitioners charged CMC with negligence in the
selection and supervision of defendant physicians and hospital staff.

The RTC rendered Dr. Estrada as solely liable. The CA affirmed the decision of the RTC.
The SC partly granted the petition. Capitol Medical Center was also found liable for
negligence of Dr. Oscar Estrada. The court also affirmed the decision of the RTC and
CA.

Issue:

Whether or not CMC is released from liability for the death of Mrs. Nogales based on
Consent on Admission and Consent of Operation.
Ruling:

No. A blanket release in favor of hospitals “from any and all claims”, which includes
claims due to bad faith or gross negligence , would be contrary to public policy and thus
void.

Even simple negligence is not subject to blanket release in favor of establishments like
hospitals but may only mititgate liability depending on the circumstances.

When a person needing urgent medical attention rushes to a hospital , he cannot bargain
on equal footing with the hospital on the terms of admission and operation. Such a
person is literally at the mercy of the hospital. There can be no clearer example of a
contract of adhesion than one arising from such a dire situation. Thus, the release forms
of CMC cannot relieve CMC from liability for the negligent medical treatment of Corazon.

Doctrine:

Doctrine of Apparent Authority

 It is a species of the doctrine of estoppel.

An exception to the general rule that a hospital is not liable for the negligence
of an independent contractor-physician is when the physician is the
“ostensible “ agent of the hospital, which exception is also known as the
“doctrine of apparent authority”.